Increasing Access to Urology: One Program’s Multifaceted Approach to Expanding the Urologic Workforce

BACKGROUND Despite evidence that physician–patient concordance improves patient satisfaction and health outcomes, the urologic workforce is less diverse than the patient populations it serves. We describe the implementation and outcomes of a multifaceted, holistic, merit-based recruitment strategy designed to expand the urologic workforce in a single academic urology residency program. METHODS Beginning in 2020, (location masked for blinded review) implemented a new multifaceted recruitment strategy, including a funded visiting student rotation to help students who are economically disadvantaged, recruitment participation in the Student National Medical Association and Latino Medical Student Association annual conferences, increased visibility of an institutional commitment to supporting physicians of all backgrounds, a merit-based holistic application review process, and implicit bias training for interviewers within the week before residency interviews. Self-reported demographic and academic data from interviewed and matched applicants between 2012 to 2019 (preimplementation) and 2020 to 2025 (postimplementation) were compared using Chi-squared testing. RESULTS Female representation among interviewees increased from 26.4% to 45.4% (p < 0.01) and among matched residents from 16.7% to 57.9% (p < 0.01). The proportion of interviewees underrepresented in medicine increased from 6.9% to 18.5% (p < 0.01) with underrepresented in medicine match rates rising from 8.3% to 21.1% (p = 0.21). Mean USMLE Step 1 scores and maximum rank list position were unchanged. CONCLUSION Intentional recruitment measures can attract top talent to the urologic workforce that more effectively reflects and meets the needs of the US patient population it serves, including funded visiting student rotations to minimize financial constraints, mentorship and support for applicants, implicit bias training before interviews, and a merit-based holistic applicant review.